Bonyadi Parisa, Saleh Narjes Tehrani, Dehghani Mohadeseh, Yamini Mahsa, Amini Kumarss
Department of Microbiology, College of Bioscience, Arak Islamic Azad University, Arak, Iran.
Department of Biomedical, Center Tehran Branch, Islamic Azad University, Tehran, Iran.
Microb Pathog. 2022 Apr;165:105461. doi: 10.1016/j.micpath.2022.105461. Epub 2022 Feb 28.
Pseudomonas aeruginosa is an opportunistic pathogen that infects the lungs of people with cystic fibrosis (CF) and is the most common cause of chronic respiratory infections with high morbidity and mortality in CF patients. This study aimed to evaluate the pattern of antibiotic resistance of P. aeruginosa strains from patients with CF using a systematic review and meta-analysis.
A comprehensive and systematic search was performed for relevant articles until August 2021 in the following database: PubMed, Scopus, Embase, and Web of Science. Finally, 122 articles with appropriate criteria were included in the meta-analysis. To estimate weighted pooled proportions Freeman-Tukey double arcsine transformation was performed using Metaprop command in Stata software version 17.1.
122 studies evaluated the pattern of P. aeruginosa antibiotic resistance from different antibiotic classes in patients with CF. Cefotaxime had the highest resistance rate of 67% (95% CI 53_80%), while colistin had the lowest 5% (95% CI 2-8%).
High resistance to most of the studied antibiotics was observed. The high antibiotic resistance observed is worrying and it indicates the need to monitor using of antibiotics. In addition, colistin is the most appropriate treatment choice, but more randomized controlled trial studies are recommended.
铜绿假单胞菌是一种机会致病菌，可感染囊性纤维化（CF）患者的肺部，是CF患者慢性呼吸道感染最常见的病因，发病率和死亡率很高。本研究旨在通过系统评价和荟萃分析评估CF患者中铜绿假单胞菌菌株的抗生素耐药模式。
截至2021年8月，在以下数据库中对相关文章进行了全面系统的检索：PubMed、Scopus、Embase和Web of Science。最后，122篇符合适当标准的文章被纳入荟萃分析。为了估计加权合并比例，使用Stata软件17.1版中的Metaprop命令进行Freeman-Tukey双反正弦变换。
122项研究评估了CF患者中不同抗生素类别铜绿假单胞菌的抗生素耐药模式。头孢噻肟的耐药率最高，为67%（95%可信区间53_80%），而黏菌素最低，为5%（95%可信区间2-8%）。
观察到对大多数研究抗生素的高耐药性。观察到的高抗生素耐药性令人担忧，这表明需要监测抗生素的使用。此外，黏菌素是最合适的治疗选择，但建议进行更多随机对照试验研究。
